Monthly Archives: January 2015

Vox reported that the 2014 Commonwealth Fund (which surveys Americans on how difficult it is to afford medical care) shows the number of Americans who say they can afford the health care they need went up for the first time.

The Commonwealth Fund fielded the survey during the second half of 2014, meaning they captured the people who signed up for Obamacare during the open enrollment period earlier in the year. And it showed, for the first time in the survey’s 10-year history, a decline in the number of Americans who reported having difficulty paying medical bills or who carried medical debt.

The Commonwealth Fund also looked at Americans who said they put off care because it was too expensive. And there, too, they saw a decline: 36 percent of Americans reported delaying care because of the price, an all-time low in the survey’s history.

This also coincided with an increase in the number of Americans who reported having health insurance, a finding that lines up with other national surveys on coverage. The Commonwealth Fund survey suggests that the plans sold on the marketplace are making it easier for the people who buy them to see the doctor — which is one of the main points of having health insurance to begin with.

Obamacare has significantly increased the number of people with health insurance coverage. It did that by overhauling the individual insurance market — where people buy their own policies — and expanding Medicaid, a public program that covers low-income Americans.

McKnights had an interesting article about the cost of getting a copy of your own medical records. Long-term care providers that charge people to access their electronic health records might be violating federal law, according to the American Health Information Management Association. The Health Insurance Portability and Accountability Act requires healthcare providers to furnish patients with paper or electronic copies of their EHR on request. The providers are allowed to charge only the related labor and supply costs, but many are not calculating their charges using these criteria, according to a recent survey done by the AHIMA Foundation and Texas State University.

The rates might violate HIPAA even if they seem to be reasonable, emphasized author Kim Murphy-Abdouch, MPH, RHIA, FACHE, of the Health Information Management Department at Texas State University. About 65% of respondents said they charge less than $1.00 per page, she noted.

The majority of survey respondents were affiliated with hospitals or integrated delivery systems, but long-term care also was represented. Click here for the complete report.

The Hill had a fantastic article on the nearly $6 billion recovered in 2014 under the False Claims Act. The FCA allows the government to seek redress from individuals or entities that have in some way caused false statements to be used in the process of securing payment of government monies. The FCA is mostly known for its “qui tam” provisions that allow private citizens — commonly called whistleblowers — to bring suit in the name of the government, and to be paid a bounty from recovered funds. The FCA makes it unlawful to file a false claim or to “cause”one to be filed. Once these suits are brought, the DOJ may intervene and pursue the case with or without the help of the whistleblower and counsel.

It turns out that of the $5.69 billion, $2.3 billion was recovered from healthcare providers, including the pharmaceutical industry, and $3.1 billion was recovered from the financial services industry including the big banks. This means that $5.4 billion was recovered from entities that had no direct procurement relationship with the federal government or the states. Marketing drugs for purposes not approved by the Food and Drug Administration, and provision of healthcare that is not medically necessary are just some examples of conduct that cause the Medicare and Medicaid systems —and state and federal health plans — to pay out dollars that should not have been paid. Most FCA recoveries have come from entities — particularly healthcare providers — where the accused culprit does not have a direct government procurement relationship.

Cincinnati.com reported that police have arrested a 57-year-old David Henson in the alleged rape of a fellow patient at Heartland of Mt. Airy nursing facility. Police allege David Henson anally and vaginally penetrated a woman with foreign objects, according to court documents. The accused and the alleged victim were both residents at the facility. Henson’s attorney said that Henson and the woman were in a “relationship” for about five or six months. The incident report states Henson became angry with the woman upon returning to the facility.

In an affidavit, the woman wrote that she asked Henson to stop, but he responded, “that’s what you get.” Henson’s family was also allegedly making threatening phone calls to the woman’s home following the arrest. Judge William Mallory ordered members of Henson’s family to stop making threatening phone calls and set Henson’s bond at $10,000.

Where was the supervision? How could the facility allow this to happen?

ABC reported that a nursing home employee was arrested for punching a 93-year-old woman. Anita Watford is charged with abuse or neglect of a protected person. Watford, a nursing assistant, is accused of punching an elderly woman in the head Oct. 31 at Glen Haven Health and Rehabilitation when she repeatedly spat her medicine out. Watford told administrators she was trying to hold the woman’s hands down when she “accidentally” hit the patient, but her statement was contradicted by witness accounts.

Los Angeles Times: Fewer Americans Delayed Needed Medical Care In 2014, Survey Says
From 2012 to 2014, the share of consumers delaying a recommended test or treatment or not filling a prescription fell by nearly a third. And the percentage who reported problems with medical bills fell by almost a quarter. Those are the first declines ever recorded by the biennial national survey by the nonprofit Commonwealth Fund, which began asking Americans about the affordability of medical care a decade ago. (Levey, 1/14)

This is a great advance for the health of the country and the long term costs of health care. Delaying treatment has been shown to cause more serious health problems and increase overall health care costs.

ABC7 reported that David Moreno, former maintenance worker for Yorba Linda assisted living senior homes, was charged and sentenced for sexually violating a 69 year old disabled woman. Prosecutors state that Moreno committed the acts from June 1st to July 24 2012, and, took advantage of the woman’s dementia and sexually assaulted her on numerous occasions. The atrocities of Moreno’s acts were not known until the woman had the courage to tell a close friend what had happened to her. Traces of Moreno’s DNA were discovered throughout the victim’s room. The charges of his deviant conduct includes 2 felony charges; one for sexual battery of an institutionalized victim and the other is for sexual penetration by foreign object of an incompetent victim.

Moreno’s sentence includes only a three year stint at a California state prison as well as having to register as a sex offender for the rest of his life. After his release from prison, Moreno will be barred from entering local recreational areas as well as city parks. Hopefully with Moreno’s lifetime sex offender registration status, companies, corporations, and small businesses may be forewarned of the sexually deviant nature that Moreno exhibits towards individuals, particularly those that are already in a vulnerable position.

KLTV had an article on Texas lawmaker Charles Schwertner who is pressing lawmakers to enact a more stringent policy towards nursing homes with established violations of abuse and neglect. Senator Schwertner has proposed legislation that, if enacted, would require the state to revoke licenses of nursing homes that have chronically presented high level deficiencies to the state.

During a Sunset Advisory Commission hearing, the senator listed out seven nursing home facilities within Texas that had a surplus of violations during their duration of service. One of the nursing homes within the senator’s jurisdiction, Eastwood Care and Rehab, located in Tyler in East Texas, acts as a focal point for how necessary and vital legislative reform can be. Eastwood recently lost its federal funding and was subject to license revocation after numerous violations were discovered within the facility. After finding over 70 separate violations from a singular inspection, the former owners of Eastwood Care and Rehab were removed from their positions, and a new company took over the facility.

Senator Schwertner wants to see a better system of enforcement within the nursing home industry. One of his proposals includes a “three strike plan” in which a facilities’ license would be revoked if three or more high level deficiencies were reported within a two year period. Additionally, Senator Schwertner emphasizes that the rules, regulations, and policies of the nursing home mandates are too vague and need to be more detail oriented in order to combat the substandard living conditions that are present in some facilities. Although the proposition has not been formally made into law, the Texas delegation are expected to wrestle with Schwertner’s plan in 2015.

The Star of Ontario conducted an investigation into the usage of potentially lethal pharmaceutical drugs. According to the survey, some doctors are continuing to use the dangerous drugs, despite the fact that many of them come with a “black-box” warning that the patient taking the pill has about a 60 percent increased risk of death after taking it. In 40 Ontarian nursing homes surveyed, more than half of the residents were on the anti-psychotic drugs, and in about 300 homes, more than one third of residents were on them. One of the nursing homes surveyed even uses the pills on 75 percent of its residents.

The pills used in the nursing homes include olanzapine, quetiapine, and about 10 other dangerous anti-psychotic drugs. These drugs come with serious side effects, including diabetes, hyperglycemia, high fever, intestinal obstruction, and rigid muscles. Though olanzapine and quetiapine were approved by the American Food and Drug Administration (FDA) for use on individuals with schizophrenia, bipolar disorder, mania in 2004 and 2005, the drugs have never been approved by Health Canada for use on people suffering with dementia. Canadian doctors were warned in 2007 by the auditor general of overuse of the anti-psychotic drugs.

One family told The Star that one of their loved ones died after the nursing home she was in administered olanzapine to her to “quiet her down.” The caregivers did so without explaining the risk to her husband who says he never would have consented to it had he known of the drug’s dangerous potential.

So if anti-psychotic drugs like olanzapine and quetiapine are obviously dangerous, and it seems as if doctors are aware of the risks that come with prescribing the pills, what can be done to prevent patients from having the drugs administered to them? Some suggest that doctors should be made to warn the patients receiving the drugs or their substitute decision makers so that they can consent to taking the drugs or refuse them. Others suggest that nursing homes should increase staff numbers and provide their caregivers with in-depth training regarding care for dementia patients. Dr. Andrea Moser says that work has already been done to limit the use of anti-psychotic drugs in nursing homes. She told The Star, “We’re making progress. We still have a long way to go.”

The New York Daily News reported Laszlo Molnar, the owner of AA Adult Family Home nursing facility has been charged with second degree rape. He is accused of sexually exploiting an 83 year old dementia patient within his own facility. The grotesque act was made tangible when the family of the affected resident decided to place video recording equipment in an inconspicuous area within her room. Soon enough, the assailant was horrifically caught in the act on tape. The family was forced to bear witness to the owner’s actions by watching the video in an attempt to achieve justice for their mother.

The other 11 residents in the nursing home have been removed and are being checked for sexual assault. With such depraved acts demonstrated by this nursing home owner, perhaps allowing video cameras in nursing homes will become commonplace.